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Functional Status and All-Cause Mortality in Serious Mental Illness

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  • Richard D Hayes
  • Chin-Kuo Chang
  • Andrea C Fernandes
  • Aysha Begum
  • David To
  • Matthew Broadbent
  • Matthew Hotopf
  • Robert Stewart

Abstract

Background: Serious mental illness can affect many aspects of an individual’s ability to function in daily life. The aim of this investigation was to determine if the environmental and functional status of people with serious mental illness contribute to the high mortality risk observed in this patient group. Methods: We identified cases of schizophrenia, schizoaffective and bipolar disorder aged ≥15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of activities of daily living (ADLs), living conditions, occupational and recreational activities and relationship factors (Health of the Nation Outcome Scale [HoNOS] subscales) on all-cause mortality over a 4-year observation period (2007–10) using Cox regression. Results: We identified 6,880 SMI cases (242 deaths) in the observation period. ADL impairment was associated with an increased risk of all-cause mortality (adjusted HR 1.9; 95% CI 1.3–2.8; p = 0.001, p for trend across ADL categories = 0.001) after controlling for a broad range of covariates (including demographic factors, physical health, mental health symptoms and behaviours, socio-economic status and mental health service contact). No associations were found for the other three exposures. Stratification by age indicated that ADLs were most strongly associated with mortality in the youngest (15 to

Suggested Citation

  • Richard D Hayes & Chin-Kuo Chang & Andrea C Fernandes & Aysha Begum & David To & Matthew Broadbent & Matthew Hotopf & Robert Stewart, 2012. "Functional Status and All-Cause Mortality in Serious Mental Illness," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-9, September.
    • Handle: RePEc:plo:pone00:0044613
    DOI: 10.1371/journal.pone.0044613
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    References listed on IDEAS

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    1. Majer, I.M. & Nusselder, W.J. & Mackenbach, J.P. & Klijs, B. & Van Baal, P.H.M., 2011. "Mortality risk associated with disability: A population-based record linkage study," American Journal of Public Health, American Public Health Association, vol. 101(12), pages 9-15.
    2. Julianne Holt-Lunstad & Timothy B Smith & J Bradley Layton, 2010. "Social Relationships and Mortality Risk: A Meta-analytic Review," PLOS Medicine, Public Library of Science, vol. 7(7), pages 1-1, July.
    3. Morrell, Stephen & Taylor, Richard & Quine, Susan & Kerr, Charles & Western, John, 1999. "A case-control study of employment status and mortality in a cohort of Australian youth," Social Science & Medicine, Elsevier, vol. 49(3), pages 383-392, August.
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    1. Joy Agner & Monet Meyer & Tyra Mahealani Kaukau & Maileen Liu & Lisa Nakamura & Adriana Botero & Tetine Sentell, 2023. "Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i," IJERPH, MDPI, vol. 20(1), pages 1-17, January.

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